Psychometric Properties of the Enfranchisement Scale of the Community Participation Indicators

Research Objectives: The content of most community participation measures is limited to participation in community activities, and lacks the personal and contextual elements that are critical to the construct of participation. The Enfranchisement scale of the Community Participation Indicators measures the sense of belonging and inclusion that is missing from other measures. However, the psychometric properties necessary for use in clinical trials have not been established. Our objective was to examine the construct validity, sensitivity to change, and cut points of this measure.

Design: We examined construct validity using cross-sectional data from a sample of adults with mixed disabilities. We examined cut points and sensitivity to change using longitudinal data in a sample of adults with traumatic brain injury (data were collected at two time points, 3 months apart). To examine construct validity, we examined correlations between the Enfranchisement scale and measures of participation, activity, and impairment. To examine cut points, we used the prospective dataset and used the software SAS PROC Logistic and the macro %ROCPlot. To examine sensitivity to change, we calculated minimum detectable change (MDC) and minimal clinically important difference (MCID).

Setting: Assessments were administered in community settings.

Participants: The cross-sectional cohort included 604 adults with disabilities; the longitudinal cohort included 44 adults with brain injury.

Interventions: N/A

Main Outcome Measures: The Enfranchisement Scale has a Control subscale and an Importance subscale.

Results: Both subscales were strongly associated with participation (Control: r=.56; Importance: r=.52) and weakly associated with cognition (Control: r=.03; Importance: r=.03). We found a cut point of 44 on the Control subscale (AUC=.75) and a cut point of 39 on the Importance subscale (AUC=.81). On both subscales, we found a MDC of 8 and a MCID of 5.

Conclusions: We found evidence of convergent and discriminant validity to support the use of the scale. Cut points resulted in good classification accuracy, providing support for their reliability. We found acceptable sensitivity to change.

Author(s) Disclosures: The authors have no conflicts of interest to declare.